101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB3869

 

Introduced 10/17/2019, by Rep. Karina Villa

 

SYNOPSIS AS INTRODUCED:
 
15 ILCS 205/10 new
215 ILCS 5/356z.33 new

    Amends the Illinois Insurance Code and the Attorney General Act. Provides that insurers that provide coverage for prescription insulin drugs must limit the total amount an insured is required to pay for a covered prescription insulin drug to $100 per 30-day supply of insulin regardless of the type and amount of insulin needed by the insured. Provides that the Attorney General shall investigate the pricing of prescription insulin drugs to ensure adequate consumer protections for Illinois consumers and to determine whether additional consumer protections are necessary. Requires the Attorney General to make the findings available to the public and to report to the Governor, the Department of Insurance, and the Judiciary Committees of the Senate and the House of Representatives. Provides for the repeal of the Attorney General's investigative duties on December 31, 2020.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB3869LRB101 12935 SMS 61771 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Findings. The General Assembly finds and
5declares that:
6        (1) Diabetes affects approximately 1,300,000 adults in
7    Illinois (12.5% of the population);
8        (2) Diabetes is the seventh leading cause of death
9    nationally and in Illinois;
10        (3) The toll on the Illinois economy has increased by
11    more than 40% since 2007, costing the State
12    $245,000,000,000 in 2012;
13        (4) When someone has diabetes, the body either does not
14    make enough insulin or is unable to use its own insulin,
15    causing glucose levels to rise higher than normal in the
16    blood;
17        (5) For people with Type 1 diabetes, near-constant
18    self-management of glucose levels is essential to prevent
19    life-threatening complications;
20        (6) From 2012 to 2016, the average price of insulin
21    increased from 13 cents per unit to 25 cents per unit;
22    therefore,
23    It is necessary for the State to enact laws to reduce the
24costs for Illinoisans with diabetes and increase their access

 

 

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1to life-saving and life-sustaining insulin.
 
2    Section 5. The Attorney General Act is amended by adding
3Section 10 as follows:
 
4    (15 ILCS 205/10 new)
5    Sec. 10. Investigation of prescription insulin drug
6pricing; report.
7    (a) The Attorney General shall investigate pricing of
8prescription insulin drugs made available to Illinois
9consumers to ensure adequate consumer protections in the
10pricing of prescription insulin drugs and to determine whether
11additional consumer protections are needed.
12    (b) As part of the investigation, the Attorney General
13shall gather, compile, and analyze information concerning the
14organization, business practices, pricing information, data,
15reports, or other information that the Attorney General finds
16necessary to fulfill the requirements of this Section from
17companies engaged in the manufacture or sale of prescription
18insulin drugs.
19    If necessary to fulfill the reporting requirements of this
20Section, the Attorney General may issue a civil investigative
21demand requiring a State agency, insurer, pharmacy benefit
22manager, or manufacturer of prescription insulin drugs that are
23made available in Illinois to furnish material, answers, data,
24or other relevant information.

 

 

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1    (c) A person or business shall not be compelled to provide
2trade secrets.
3    (d) By November 1, 2020, the Attorney General shall issue
4and make available to the public a report detailing the
5findings from the investigation conducted pursuant to this
6Section. The Attorney General shall present the report to the
7Governor, the Department of Insurance, and the Judiciary
8Committees of the Senate and House of Representatives or their
9successor Committees. The report must include the following:
10        (1) a summary of insulin pricing practices and
11    variables that contribute to pricing of health coverage
12    plans;
13        (2) public policy recommendations to control and
14    prevent overpricing of prescription insulin drugs made
15    available to Illinois consumers;
16        (3) any recommendations for improvements to the
17    Consumer Fraud and Deceptive Business Practices Act; and
18        (4) any other information the Attorney General finds
19    necessary.
20    (e) This Section is repealed on December 1, 2020.
 
21    Section 10. The Illinois Insurance Code is amended by
22adding Section 356z.33 as follows:
 
23    (215 ILCS 5/356z.33 new)
24    Sec. 356z.33. Cost sharing in prescription insulin drugs;

 

 

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1limits; confidentiality of rebate information; definition;
2rules.
3    (a) As used in this Section, "prescription insulin drug"
4means a prescription drug that contains insulin and is used to
5treat diabetes.
6    (b) An insurer that provides coverage for prescription
7insulin drugs pursuant to the terms of a health coverage plan
8the insurer offers shall limit the total amount that an insured
9is required to pay for a covered prescription insulin drug at
10an amount not to exceed $100 per 30-day supply of insulin,
11regardless of the amount or type of insulin needed to fill the
12insured's prescription.
13    (c) Nothing in this Section prevents an insurer from
14reducing an insured's cost sharing by an amount greater than
15the amount specified in subsection (b).
16    (d) The Director may use any of the Director's enforcement
17powers to obtain an insurer's compliance with this Section.
18    (e) The Department may adopt rules as necessary to
19implement and administer this Section and to align it with
20federal requirements.